ANNAPOLIS – With a growing dental-care crisis in rural Maryland, lawmakers are trying to find ways to attract dentists to underserved areas – and keep them there.
Bills to increase dentists’ Medicaid reimbursement rates, provide tax breaks for dental equipment, permit retired dentists to practice and provide grants for dental school debt are on both chambers’ agendas.
Dentists say the deficiency stems from poor Medicaid reimbursements that pull practitioners away from areas laden with poor patients toward dense and high-income areas where their work is more profitable.
Dental organizations back all the bills but are pinning their highest hopes on a bill from Delegate Ronald A. Guns, D-Cecil, to mandate increased state funding for its dental Medicaid program, HealthChoice.
“That bill gets at the core of the problem,” said Elza Harrison, executive director of the Maryland State Dental Association. “The rest of the bills are only working at the symptoms.”
Dentists have been severely underpaid for Medicaid patients, Harrison said. Before HealthChoice came to the state in 1997, dentists were reimbursed only 20 percent for Medicaid patients. Now they receive 50 percent, but that doesn’t even cover overhead, she said.
As a result, many dentists refuse to participate in Medicaid, she said.
“You can’t run any kind of business when you are losing money,” she said.
Guns’ bill would raise Medicaid reimbursement rates to 85 percent by 2003, matching physicians’ Medicaid reimbursements.
Lawmakers have filed a pack of bills offering other incentives to new and retired dentists.
“There needs to be a combination of things (dentists) can tap into,” said Delegate Verna Jones, D-Baltimore, key sponsor of three dental bills.
One of her bills would grant property tax credits to dentists who practice in areas designated by the state as underserved. Another would provide help for dental students to repay school loans, which can run $100,000. The last would offset costs of dental equipment with tax credits for practices in areas lacking dentists.
The Senate passed two measures Thursday to help lure dentists to such areas. Prince George’s Democrat Sen. Gloria Lawlah’s bill would form an independent fund to relieve up to $99,000 of a dentist’s debt over three years.
A bill by Sen. Paula Hollinger, D-Baltimore County, would establish a license for retired dentists to volunteer to continue practicing. Continuing education would be required to ensure they remain qualified.
These bills are a good start in drawing students to low-income areas but, “there is still a long way to go,” said Dr. Richard R. Ranney, Dean of University of Maryland’s Dental School.
Dr. Mark L. Wagner, University of Maryland Dental School professor, just hopes the focus will always be the health of the children: “You know, we can talk about politics, but at the bottom of all of this, these kids can’t vote, and they are suffering. It breaks my heart every day.”